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Cant close my hand - feels swollen but it's not. I've had…

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Cant close my hand...

Cant close my hand - feels swollen but it's not.

Doctor's Assistant: Any recent injuries? How long have you been dealing with the swelling?

I've had some mild carpal tunnel in the past. Played a lot of tennis this weekend. hand was little sore after but when I woke up this morning, wow - putting my thumb with any finger causes horrible shooting pain in the thumb

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I take medication for high blood pressure and had a hip replacement a year ago

Submitted: 6 months ago.Category: Neurology
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Answered in 14 hours by:
12/19/2017
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 6 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,321
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I am sorry to hear about your health in the form of the new symptoms in the right hand including the right thumb you have described above. As a Neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

The types of symptoms you are now having, and the antecedent events prior to the onset of these new symptoms in the form of having played lot of tennis and some sore feeling in the hand after the play indicate this is most likely musculoskeletal type of issue

It appears musculoskeletal issue because you are having horrible shooting pain while attempting to put the thumb with any fingers and this type of clinical manifestation is highly suggestive of musculoskeletal type of problem in the hand, and this appears related to irritation or inflammation of the musculoskeletal structures of the hand such as muscle, or ligaments, or tendons, or bone or joints of the hand etc. Among the various musculoskeletal structures mentioned above it appears most likely the tendons controlling the thumb have been irritated or inflamed (Tendon strain) and this condition is also called as tendonitis.

Tendonitis can cause excruciating pain, especially when you move the affected part, as is happening in your case where the pain is horrible in nature as you try to move the thumb, and the pain is also preventing you from closing the hand.

While you have some CTS (Carpal tunnel syndrome) too but it does not appear these new and severe symptoms are due to CTS, since this type of acute worsening that too presenting with this much of severe pain is not a feature of CTS

So this appears tendonitis of the thumb that is causing all these new onset symptoms.

Since the symptoms are very severe if possible try to get this examined & investigated by your dr and then treated appropriately. The investigations may require certain specific blood tests, an x ray of the hand/thumb, and later if required an MRI scan of the hand and thumb region too. The blood tests will also check for another condition called as gout arthritis that too can cause these types of symptoms you have been having.

The following are the various treatment options that can be tried to help with your condition;

A) First of all what we need to do is protection from further injuries by avoiding various physical activities that can cause this type of injury again and/or exacerbate it, and the following physical activities need to be avoided as much as possible;

Avoiding excessive hand or finger movements, grabbing, gripping etc with the affected hand

Avoiding lifting or carrying heavy weight or heavy objects, or pushing and pulling or overstretching with the affected limb

Avoiding any physical activities which increase the pain

Avoiding overusing or over straining the affected area as much as possible

The above physical activities or situations need to be avoided as much as possible because all these can strain the hand & thumb tendons further, and also can exacerbate the pain, and possibly delay the healing too

B) The following are the various General measures, and/or Home remedies, and/or OTC (Over the counter) treatments that can be tried to help with this condition;

Trying PRICE protocol – this is the treatment of choice during acute conditions like this and PRICE is the acronym for;

Protection

Rest

Ice (Cold therapy)

Compression (if swelling is present, not otherwise)

Elevation (if swelling is present, not otherwise)

In addition to the above the following measures can be tried too;

Adequate resting till the inflammation heals

Gentle stretching exercises of the hand muscles (provided it does not elicit severe pain)

Massaging the painful areas is also very useful

Using one of the over the counter oral anti-inflammatory Pain killers such as Tylenol, or Naproxen (Aleve) or Ibuprofen (Motrin, Advil) etc

Using one of the over the counter locally acting ointments, or sprays of anti-inflammatory pain killers (Muscle rubs) such as Myoflex or Biofreeze etc, other similar options include - Penetrex, Bengay Ultra Strength, Arnicare, Aspercreme with Lidocaine etc

Using one of the over the counter essential oil rubs such as Eucalyptus oil, or Wintergreen oil

Using Epsom Salt Compress or Epsom Salt Soaking of the affected hand etc

C) If symptoms do not improve with the above therapeutic interventions then the following additional treatment measures can be considered;

A course of PT (Physical therapy) to the affected hand and fingers

Stronger prescription anti-inflammatory painkillers like Tramadol

Nerve-pain pills like Gabapentin, or Amitriptyline

Muscle relaxants like Baclofen, or Tizanidine

A course of oral steroids

Steroid Iontophoresis

Narcotic pain killer like Lortab or Percocet

Hot fomentation

Short wave diathermy

Infra-red light therapy

Ultrasound therapy

TENS (Transcutaneous Electric Nerve Stimulation)

Interferential therapy

Laser therapy (Cold laser therapy or Low Level Laser Therapy)

Steroid shots etc

D) If the above therapeutic measures do not sufficiently help in relieving the pain and healing process then one of the following special injection treatments can be tried;

PRP (platelet Rich Plasma) injection

Prolotherapy injections etc

Please see I am not telling all these above mentioned treatments are required in your case; I am trying to provide a list of the various treatment options like this so that you are familiar with various treatment options that are available for your condition and you may try to use them as necessary. If you see any of the above treatments you have already tried please disregard them and you may explore the treatment options which you may have not yet tried.

In addition to the above, you may also consider trying certain over the counter/non-prescription nutritional supplements such as the following ones;

Methyl Guard Plus (which is a combination of active forms of vitamin b12, vitamin b9/folate, vitamin b6, vitamin b2)

Vitamin B1 (Benfotiamine)

Vitamin D

ALA (Alpha lipoic acid)

Acetyl L Carnitine

Coenzyme Q10 etc

These above mentioned nutritional supplements too can help in getting relief from the pain, and also assist with faster recovery too.

To summarize once again;

1) Please see this rapid onset and severe symptoms including horrible shooting pain is most likely secondary to Tendon strain (Tendonitis). Another possibility to consider is gout as mentioned above

2) A thorough examination in the clinic followed by undergoing certain relevant investigations as mentioned earlier above can help us in finalizing the diagnosis and then treated appropriately

3) In the meantime you may try some of the treatments mentioned earlier above and these can help in providing relief from the annoying, bothersome symptoms you have been experiencing, as well as help you with faster recovery too

4) And also very importantly, please see this type of health issue can be diagnosed & successfully treated, so please not to be scared or not to lose hopes, an early diagnosis & treatment gives the best chance for quick & complete cure so please try to see your doctors asap and try to undergo a thorough clinical examination & relevant investigations as discussed earlier above, for the best results.

Wishing you a quick & complete recovery! And also Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. And please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 6 months ago

Hi, have you received the answer I have posted above? And have you had a chance to go through the above answer?

Do you have any additional health questions? Do you want to discuss further the health concerns you have mentioned above, or any other health related concerns?

Please let me know and I am available here.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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